Background: Abdominoperineal resection (APR) is a major colorectal operation resulting in permanent end colostomy. Perineal wound morbidity remains a significant complication of APR. This study investigates the burden of wound morbidity in APR and compares different wound closure techniques. Methods: We conducted a retrospective audit of patients who underwent APR at Waikato District Health Board between January 2005 and March 2016. Data was collected on closure techniques (simple suture closure [SSC], SSC with vacuum-assisted closure [SSC+VAC], mesh-assisted closure [MAC], and vertical rectus abdominis myocutaneous flap [VRAM]. Primary outcomes included surgical site occurrence (SSO) within 30 days, and secondary outcomes included perineal hernia rates, perineal wound morbidity, and length of stay. Results: Out of 117 identified patients, 97 met the criteria for analysis. The study found an overall wound SSO rate of 32.0%. No significant differences in wound SSO rates were observed between different closure techniques (SSC, SSC+VAC, MAC, VRAM). Perineal hernia rates were overall low (7.0%), and no significant difference in hernia rates among the closure techniques. Preoperative pelvic radiation was associated with higher rate of wound SSO (96.78% vs. 69.70%, p=0.006). Length of stay was significantly longer for patients with wound SSO (22.7 days vs 13.2 days, p=0.007) and lead to greater return to theatre (70.97% vs 16.67%, p<0.001). Discussion: APR is associated with substantial perineal wound morbidity however closure techniques did not significantly influence wound outcomes. Wound SSO leads to greater length of stay and reoperation. Minimizing wound complications in APR is important to improve patient outcomes.